Friday, July 31, 2009

My Motivation

A runner fights his way across the San Francisco's Golden Gate Bridge.

Ever see those motivational posters with the inspiring photography and pithy sayings? I've always given them a passing glance, testing them, but never really embracing any of them. It got me thinking the other day of what would be my own motivational saying; something that resonates with me? I think if I had to choose I would steal a quote from Lance Armstrong, "Pain is temporary, quitting is forever". I've often thought of this during races when it would be so easy to let off the gas and end the pain, or at least temporarily relieve it. As I suspect with Lance as well, it's gotten me through some tough spots, allowing me to persevere and push through to the very end.

Friday, July 17, 2009

Bug Squishers

Buddha statue in a San Francisco garden.

Empathy is the seed of compassion, the one emotion that I want to imbue on my 5-year old son. I believe that with empathy towards himself and others that he will grow to be a more caring and loving individual; every parent's dream. All that is fine and good, but how do you teach a 5-year old empathy, especially when they're so ego-centric? This is my koan. My wife pointed out that both my son and I can learn empathy together, since we're both equally lacking. It's always reassuring to find out that your spouse thinks you have the emotional maturity of a 5-year old, but that's another subject in it's own right.

The best teacher is experience. Children learn by observing and doing, which means that he must observe empathy before he can practice it. We try hard help him identify his own feelings at any given time, and ask him if he can guess how others feel. "What about the bug that you just squished?" Right now it all comes down to physical discomfort, which is easier for a 5-year old to identify with, everything is black and white. Later we hope that he can identify emotional suffering in both himself and others, and truly associate his feelings' sort of the First Noble Truth for 5-year olds.

Thursday, July 16, 2009

Urban Violence

Looking skyward on the Golden Gate Bridge.

Called to a 12-year old boy, gunshot in the chest. Lights and sirens, moving through traffic as quickly as we can; arriving we find three fire engines, four police cars, and fifty some-odd people gathered around on the grass. In the stairwell lies a young African-American boy in a puddle of his own blood. Firemen are viciously pumping on his tiny chest, sweat pouring down their faces. A hole the size of his little fist is evident on the left side of his chest. No pulses, or breaths; pupils are dilated and non-reactive. It seems futile but we work him as hard as we can. He's pronounced in the ER within moments of arrival.

Urban violence was something that I was never exposed to both as a youth and even later as an adult. It's reality is stark and obscene, and you don't know wether to cry or scream as you stare at it's aftermath. You're angry at everyone involved, even the victim himself draws your ire.

Monday, July 13, 2009

A Win-Win For Everyone

I brought a patient into the ER the other night and found myself right in the middle of a classic EMS conundrum; that of a dramatically improved patient. My patient had had a severe allergic reaction and was all but unconscious, laying on the floor when we arrived at the scene. There was no family around that could give me any history to my patient's condition so I was forced to treat based on presentation using my best clinical judgment.

The treatment for anaphylaxis is pretty straight forward and after forming my clinical impression I immediately began administering the appropriate medications. During the 10- minute trip into the hospital the patient began to "come around" and answer my questions; by the time I got her in front of a young (and new) PA she was wide awake and sitting up in bed. The PA then proceeded to take 20 minutes and interview the patient about her current condition and past medical history, a luxury I that never had. In the end the PA, in an entirely too condescending attitude, began to question my treatment as being overly aggressive.

I took this experience as an opportunity to exam my ego. My initial reaction was to become defensive about my treatment of the patient and lash out in a retaliatory attack against the self-important PA. Staying in the moment I recognized what was going on and thanked the PA for her guidance/input, and left to do my paperwork; a win-win for everyone involved.

Saturday, July 4, 2009

Time Management

Triathlon season is going full-force. The immense amount of training is taking up almost all of my free time; what little is left over from working on a 911 ambulance over 40 hours a week. My family is being supportive, seeing me wander into the house after working all night, and then heading off to a scheduled workout. I'm not truly sure why I do this, maybe I need to look deeper into my motivations. It shouldn't be hard to do, I'm not all that complicated.